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Child sexual exploitation: improving recognition and response in health settings

Child sexual exploitation (CSE) is a form of child sexual abuse. Children and young people affected by sexual exploitation can present with a range of physical and/or emotional problems to a wide range of health settings. It is therefore essential that doctors across all specialties as well as other health care professionals are aware of the range of presentations and that they know how to respond appropriately. The purpose of this report is to make recommendations to the medical Royal Colleges and Faculties to help:

  • Raise professional awareness of the indicators of sexual exploitation in order to identify children and young people affected by sexual exploitation who are presenting to health settings
  • Support health care professionals in communicating with and engaging young people in this situation so that they are encouraged to share information with professionals
  • Ensure that health care professionals feel equipped to refer sexually exploited children in a safe and appropriate manner to local services for assistance.

The Academy of Medical Royal Colleges (the Academy) is the coordinating body for 21 medical Royal Colleges and faculties which represent over 220,000 doctors across all fields of medicine. The working group had representation from several medical Royal Colleges and Faculties and is grateful for the contributions it received from other health disciplines and groups. Children and young people who are sexually exploited can present across a range of health settings in a variety of ways: poor self-care, injuries, sexually transmitted infections, contraception, pregnancy, termination, drug and alcohol problems, medically unexplained symptoms, mental health problems, self-harming behaviours, problem behaviours, problems in relationships. They may not recognise they are being sexually exploited as they may perceive the perpetrator as giving them something they need or want. This may change over time as the perpetrator’s behaviour becomes more coercive, but, a fear of potential consequences may stop them from disclosing.